It has been a great decade for Medicare Advantage and for the private insurers that serve them. Enrollment has grown steadily, those aging into Medicare now are used to being in managed care, and profits are high. The recent open enrollment period appears to have added significant new members to a number of plans. (MFA Analysis) Overall, as of March 1, 2019, MA membership was about 22,655,000 out of around 64.5 million total Medicare beneficiaries; a gain of over 1,550,000 people from the same time last year. Stand-along Part D drug plans had membership of 25,559,801, a gain of 38,800. PDP membership is about two-thirds of the FFS population in Medicare and that enrollment growth largely reflects aging in and is attenuated as MA grows and draws members from traditional Medicare. As has been the case in recent years, the leaders continued to demonstrate substantial growth. The top ten companies account for about 73.5% of all MA membership and collectively experienced 11% growth in the last year. UnitedHealth has over 5.75 million beneficiaries, and gained over a half a million in the last year. Humana is in second, but has almost 1.7 million fewer members at 3.96 million with growth of 425,000 in the last year. Aetna is in third, followed by Kaiser and Anthem. Aetna had very strong growth of 28%, and you wonder if marketing at CVS pharmacies helped with that. Anthem also had excellent growth. Highmark and Wellcare were the only members of the top ten to experience membership declines. The recently announced combination of WellCare and Centene will create the sixth largest firm in the MA market. About 20% of members come from group employment retiree plans, and UnitedHealth has a very substantial lead in that segment. 61% of MA enrollees were in an HMO-type plan design and 36% in a PPO one. About 376,000 dual eligibles are in MA. Eight companies control about 93% of the PDP market, led by CVS with around 6.1 million members, followed by UnitedHealth at 5.4 million and Humana at 4.9 million. If CVS can convert any significant number of PDP members to MA, you can see the benefit to Aetna.
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Author Kevin Roche
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry through Roche Consulting, LLC. Mr. Roche is available to assist health care companies through consulting arrangements and may be reached at firstname.lastname@example.org.